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Home My WebLink About04-01-15 (2) pennsytvania 1505614101 EX(03-14) ' REV-1500 OFFICIAL USE ONLY t County Code Year. File Number. Bureau of Individual Taxes INHERITANCE TAX RETURN Ml:�- Ha BOX 280601 MHarrisburg, PA 17128-0601 RESIDENT DECEDENT [7--- g ENTER DECEDENT INFORMATION BELOW , % Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY oIA ? ; L1101�z �1 � a 11ai. � Decedent's Last Name Suffix Decedent's First Name MI (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1.Original Return p 2.Supplemental Return O 3. Remainder Return(date of death r„ prior to 12-13-82) O 4.Agriculture Exemption(date of O 5. Future Interest Compromise(date of O 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) . , O 7. Decedent Died Testate O 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes , (Attach copy of will.) (Attach copy of trust.)-. O 10. Litigation Proceeds Received O 11. Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) O 13. Business Assets O 14.Spouse is Sole Beneficiary t (No trust involved) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number. First Line of Address Second Line of Addressrn rrj rj 4 ,r City or Post Office qq State ZIP Code r . Correspondent's email address: REGISTER,b.WILLS USE ONL i.:. fV REGISTER OF WILLS USE ONLY ±' DATE FILED MMDDYYYY T-M DATE FILED STAMP s '1 PLEASE USE ORIGINAL FORM ONLY Side 1 150 6141�iiiiiilii 1 1505614101 �1 1 11 1505614201 , REV-1500 EX • Decedent's Social Security Number Decedent's Name: RECAPITULATION a- 1. Real Estate(Schedule A). ... .. .. .. .. .... ..... ......... ... .. .... .. .... 1. 2. Stocks and Bonds(Schedule B)r. ..... .... . ......... .. ..... .. ... . .... .. 2. • 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ... . . 3. • 4. Mortgages and Notes Receivable(Schedule D) .... . ... ..... ..... .. .. ..... 4. • 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)... .. .. 5. 6. Jointly Owned Property(Schedule F) O Separate Billing Requested ... .. .. 6. S G�' o 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property t (Schedule G) O Separate Billing Requested.. .. .... 7. ILE 8. Total Gross Assets(total Lines 1 through 7)....... .... ... .. .. .. ... . . .. .. 8. 9. Funeral Expenses and Administrative Costs(Schedule H).. ..... .... .. .. .... 9. 10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I). .. ... . ... .. .. . 10. 11. Total Deductions(total Lines§:and 10)....•..... .. .. .... ... .. .... ........ 11. 12.. Net Value of Estate(Line 8 minus Line 11) .... .. .... ... . ..... .... .... ... . 12. I 13. Charitable and Governmental Bequests/Sec.9113 Trusts for which an election to tax has not been made(Schedule J) .. . ..... .... . ...... .. ... 13. ,r 14. Net Value Subject to Tax(Line 12 minus Line 13) .. ...... ....... .. .... ... 14 +6 6 L v TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES f 15. Amount of Line 14 taxable , '=at the-spousal tax rate,or ro�oi _ transfers under Sec.911.6 �-�(a)(1.2)X-0 15. 16. Amount of.Line 14 taxab e 0 at lineal rate X_Ao �J. ;,� 16. �) �{ 17:'Amount'of;Line'14 taxable at sibling rate X.12 00 17. r 18.• Amount of Line 14 taxable at collateral rate X.15 I 18. • 19. TAX DUE . .. ..... .... .... .... ..... .. .. ... .. .... .... ......... .. .. .. 19. - 3• :0 Q 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0• Lop _ 16 ;;� -Is Under penalties of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has any knowledge. SIGNATOR PN RES SIB R FILING RETURN ATE r < DD SS 52, -4- SIGNATURE -SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RETURN DATE ADDRESS Side z 1 0� �iiiii L 61420 1505614201 ,�� REV-1.509 EX+(art 10) -Y,pennsylvania SCHEDULE F DEPARTMENT OF REVENUE W4ERITANCETAX RETURN 30IMi`LY-OWNED PROPERTY R151DEJNT DECEDENT ESTATE OF: FILE NUMBER: if an asset became Jointly owned within one year of the decedent's date of death,it must be reported on Schedule G. SURVIVING JOIN'TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT JOINTLY OVVNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOIN' MADE ITMDF NAME OF FINMICIAL INSTITUTION AND BAMC ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF NUMBER TENANT low IDF MFYM MTMBEFL ATTACH DEED FOR IOINM HERD REAL ESTATE. VALUE OF ASSET iuiEIXEST DEUDRTM unlRerT 1. A. ( a0 6 6 TOTAL(Also enter on Line 6, Recapitulation) $ 6 G�. 00 If more space is needed,use additional sheets of paper of the same size. Send Inquires to: Statement of Accounts SM Louise Drive PO Box 40 Mechanicsburg,PA 17055 Apr 25, 2011 thru May 24, 2011 www.membersist.org Main Switchboard: (800)283-2328 EZ Call: (71 7)697-4372 or(800)283-4372 Account Number: 320604 TDD: (717)697-5312 or(800)283-2328 ext.5312 Tei ranch: (800)237-7288 Balances at a Glance: MEMBERS I,' LA10 FEDERAL CREDrr UNION Checking: 132.97 16487 1 AT 0.365 32973-16487 Savings: 5. 19 1111111111111111 11111111111 11111111$pill 11111111111 Certificates: 1 ,159.84 FLORENCE A BRYNER Loans: 0.00 STEVEN BRYNER Money Management: 0.00 C/0 STEVEN B BRYNER CD 324 PEACH GLEN ROAD Swipe 5 YTD Reward: 0.00 GARDNERS PA 17324 Page: 1 of 2 Your aggregate balance as of May 1st is $1,ja8-M. An aggregate balance of$2,500 and having 3 products -place you in the Silver MLR level. Would you like to be able to Deposit Anytime Anywhere? See the enclosed insert for more details. CHECKING ACCOUNTS 0011 -CHECKING Date Transaction Description Additions Subtractions Balance Apr 25 Balance Forward 347.97 Apr 25 Check 000424 Tracer 0001170540 25.00- 322.97 Apr 26 Check 000428 Tracer 0001325563 150.00- 172.97 May 02 Check 000427 Tracer 0001081008 40.00- 132.97 May 24 Ending Balance 132.97 CHECK SUMMARY Check # Amount Date Check # Amount Date 000424 25.00 Apr 25 000428 150.00 Apr 26 01)0427' 40.00 May 02 Asterisk next to number indicates slop In number sequence 3 Checks Cleared for.215.00 SAVINGS ACCOUNTS 0000-REGULAR SAVINGS Date Transaction Description Additions Subtractions Balance Apr 25 Balance Forward 5.00 Apr 30 Deposit Dividend 0.2509/6 0.19 5.19 Annual Percentage r/e/d Eamed 0.250%from 0410112011 through 0413012011 May 24 Ending Balance 5.19 CERTIFICATE ACCOUNTS 0049-12 MONTH CERT MONTHLY Maturity Date-Dec 28, 2011 Date Transaction Description Additions Subtractions Balance Apr 25 Balance Forward 5 *1-19.17- Apr 30 Deposit Dividend 0.7009/o0.67 ,159.84 Annual Percentage YA--Id Eamed 0.710'%fiom 0 410 1120 11 ffirough 0413012011 --- Continued on following page --- Send Inquires to: Main Switchboard:5000 Louise Drive (800)283-2328 ILIi�' iL11 PO Box 40 EZ Call: (717)697-4372 or(800)283-4372 Apr 25, 2011 thru May 24, 2011 Mg Mechanicsburg,PA 17055 TDD: (717)697-5312 or(800)283-2328 ext.5312 31974-16497 Account Number: 320604 www.memberslst.org TeieBranch: (800)237-7288 Page: 2 of 2 Date Transaction Description Additions Subtractions Balance May 24 Ending Balance 1,159.84 YTD SUMMARIES TOTAL DIVIDENDS PAID * 0000 REGULAR SAVINGS 1.16 0011 CHECKING 0.00 ^' 0049 12 MONTH CERT MONTHLY 2.67 0 Total Year To Date Dividends Paid 3.83 NOTE: Total includes closed shares Don't forget about our new Member Loyalty Rewards Program. The more products you have with us, the more benefits you'll receive. A_sk.an_ass -ciateJ-or detailsor-visit our_w-ebsite_at w-w-w.memberstst o.W-otdetails __.__ _ OMB Aooroval No.2502-0265 �6 A.Settlement Statement(HUD-7) FINAL 13.Type of Loan 1.❑FHA 2 ORHS 3.Q✓Cate.Urlels. 6.Fla Number. 7.L-Number &mottgage MvawamCare Nutter. 4.❑VA 5.0Gom.Ins- KWC66752 911328899 C.Note: Ttaform is hnishd b 4you a sfalamentd actual sellaterdwsts Amoubpaid band by the setlemat agmtae shoees.netts tteded'tpa.cy were paid outside iedoebtg;aeyae st-teefurWonnatk. pup-atdaterelmcldedbtiebfals. D.Name S Address d Banower. E NanefiAddessd Se1et. F.Nave 8 Adder d Later NATHAN R-BARD IV AND NATHAN R.BARD JR. STEVEN B.BRYNER AND DAYNA BRYNER FAIRWAY INDEPENDENT MORTGAGE 130 LEHMAN DRIVE 32 W WILLOW STREET CORPORATION,ISAOA/ATIMA CARLISLE,PA 17013 CARLISLE PA 17013 1150 LANCASTER BLVD. MECHANICSBURG.PA 17055 FLORENCE A-BRYNER G_Prtgaty Lnra(an- H.Semernent Agat PINNACLE LAND TRANSFER,LIC I-SetemaadDab 1 Detus-d Date 32 W WILLOW STREET 4242 CARLISLE PIKE,SUITE 151-8, 300`15 f 3123/2015 CARLISLE,PA 17013(CUMBERLAND) CAMP HILL,PA 17011 V1 7)920-3331 (04-224483-092) Pkwe DLSdaanart 4242 CARLISLE PIKE,SUITE 151.8, CAMP HILL,PA 17011 (717)920-3331 J.Summary of Sorrowees Transaction K.Summary of Sellers Transaction 100.Gross Amount Doe From Borrower 400.Gloss Anon t Due To Seib 101.Cortimtsaiesprim $105,000.00 401.Conal Seim puce $105,000.00 102 Persons 402 Personal 103.Settleme d Charrges to Barmw ne 1400 $6,609.82 403. 104. 404. 105. 405. A(Rusbroft for items paid by seller in advance ALOLLsbnents for Mm paid by seller hl advance 106.Cilydborn fazes 406. taxes 107.Co/Tawn tares 323015 to 1112016 @$733.80/Year $570.96 407.Coffown tares 3232015 to 1112016$;f33.801Year $570.96 108.SdmW Taxes 30-7112015 @$1,560.6311'ear $1,214.30 408.Scholl Taxes 3237/112015 @$1,560.631Year $1214.30 109. 409. 110. 410. 111. 411. 112 412 120.Glens AnxKW Due From Borrower $111M.08 420_Gloss Amount Due To Se[W $1 78526 20D.Amounts Paid ByOrIn Bet M OL Borrower 500.Reductions M Amount Due To Seller 201.Deposit or EamestMoney $1.000.00 501.Exoess See irStrUC ions 2D2Pfincipalammmitofnewlew $63,000-00 502 Sella ment ChMes to Seller 1400 $9,424.88 2D3.Existing ban taker)sebpdto 503.E*bM ban taken to 204.Lemkr Paid BonowerCosls $200.00 504.Payoffoflkst mortgage ban 205. 5D5.Payoff of second modgage ban 206.SelterAssislance $5,370.00 506.See Addendum 506 55.370.00 207- 507.Disbursed as wom&$1.000.00 208. 508. 209. 509. MX%hmft for Rem urverid by sella ror items unpaid by sever 210.Cityltown taxes 510. taxes 211. taxes 511.Cotft taxes 212.Assessments 512 Asseswa* 213. 513. 214 514 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220 Total Paid ByfFor Bormwa $69,570.00 520.Total Reduction Arnowd Due Seller $1 79488 300.Cash At Seltleowd Fmmffo Borrower 600.Cash At Setilment TdFmm Sella 301.GmssAwamsd eFromBarom 120 $113,395.08 601.Gross Amount Due To Seem ft1 42D) $106.78526 302.Less Amounts Paid BytFor Borrower "e 220 $69,570.00 602 Less Dediction in Ant Due To Seller $14.794.88 303 Cash ./❑Fran ❑To Borrower $43,825.08 fiO3 Cash �✓To QfiornSeger $91,990.38 Previous editions are obsolete Page 1 of 4 03202015 08:12 AM HUD-1 D E MADE THIS lst day of April, 1992, in the year of our Lord one thousand nine hundred Ninety-Two (1992), between DORIS A. ZEIGLER, single woman, of Carlisle, Cumberland County, Pennsylvania, grantor, a n d STEVEN B. BRYNER, DAYNA BRYNER and FLORENCE A. BRYNER, of 364-Peach Glen Road, Gardners, Pennsylvania, grantees, WITNESSETH: that in consideration of Seventy-two Thousand Five Hundred and no/100($72,500.) in hand paid, the receipt whereof is hereby acknowledged, the said grantor does hereby grant and convey-to the said grantees, their heirs and assigns, as to husband and wife tenants by the entireties and otherwise as joint tenants with the right of survivorship, ALL that certain tract or parcel of land, situate, lying, and being in the Borough of Carlisle, County of Cumberland, State of Pennsylvania, being more particularly described according to survey of Noel B. Smith, Registered surveyor, dated April 8, 1969 as follows to wit: BEGINNING at a point at the Southwest corner'of West Willow Street and School Avenue, thence extending along School Avenue South 14 degrees 45 minutes West, 113 feet to a point; thence North 75 degrees 15 minutes West 26.5 feet to a point, thence North 14 degrees 45 minutes East 113 feet to a point on the South side of West Willow Street; thence along same, South 75 degrees 15 minutes East 26.5 feet to the point and place of Beginning. HAVING thereon erected a dwelling house known and numbered as 32 West Willow Street. BEING the same which William R. Capshaw and Doris Ann Zeigler, Executors of the Estate of Waymon D. Capshaw a/k/a W. D. Capshaw granted and conveyed by deed dated January 29, 1988 and recorded in the Recorder of Deeds Office for Cumberland County in Deed Book "E", Vol.'33 page 401-,.tc�,-r.-�.ris Attn-Zeigler, grantor herein. __ AND the said grantor covenants and agrees that she will jwarrant specially the property hereby conveyed. 8orouph at "/// 6 Cumb.Co.,Pa. School DPA Comb.Co.Pa. L96 Real Emma?rwzft Tax�D %Ree!Evale TranfMr TM Oita Amt Robert P.Zf"W BOQX 35 223 Robon v Zlepler Cumb.Co.Dlet Col.Aqt Cumb-Co.Dist CoL Apt REV-1511 EX+ (10-09) N pennsylvania SCHEDULE H DEPARTMENT OF REVENUE FUNERAL EXPENSES AND INHERITANCE TAX RETURN.. ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUNBER decedent's debts must be reported on Schedule 1. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: i. r t 0 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Personal Representative(s) Street Address City State ZIP Year(s)Commission Paid: Z. Attorney Fees: 3. Family'Exemption: (If decedent's address is not the same as claimant's,attach explanation.) Claimant Street Address City_ State ZIP Relationship of Claimant to Decedent 4. Probate Fees: 5. Accountant Fees: 6. Tax Return Preparer Fees: . 7. TOTAL(Also enter on Line 9, Recapitulation) $ If more space is needed, use additional sheets of paper of the same size. 219 North Hanover Street Carlisle,Pennsylvania 17013 717.243.4511 toll free 1.866.451.4511 �,�� fax 717.243.3723 �f www.hoffmonroth.com Q'� FUNERAL HOME & CREMATORY, INC. infoCaboffmcmroth.com April 29, 2011 Steve Bryner 324 Peach Glen Road Gardners, PA 17324 Statement of Funeral Expenses for: Florence A. Bryner Date of Death: April 23, 2011 Account Id: 16230-101 PACKAGE: Immediate Cremation OPTION 5 -Cremation $ 1,890.00 Sub Total: $ 1,890.00 TOTAL FUNERAL HOME CHARGES: $ 1,890.00 CASH ADVANCES: 6 Certified Death Certificates at$6.00 each $ 36.00 Newspaper Notice-Sentinel $ 84.78 Coroner's Fee $ 25.00 Sub Total: $ 145.78 Total Funeral Expense: $ 2,035.78 Balance: $ 2.035.78 ------------------------------------------------------------------------------------- Please return this portion with your Remittance. $ Amount Enclosed Florence A. Bryner Service ID#: 16230-101 SERVING OUR COMMUNITY SINCE 1 9 0 7 REV-1500 EX Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME STRE TADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1)��, 0 o 2. Credits/Payments A.Prior Payments B.Discount (See instructions.) Total Credits(A+B) (2) 3. Interest 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2,Line 20 to request a refund. (4) 5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 1 6 a -C T Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred .......................................................................................... ❑ b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ c. retain a reversionary interest .............................................................................................................................. ❑ d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ 2. If death occurred after,Dec.12,1982,did decedent transfer property within one year of death without receiving adequate consideration?.............................................................................................................. ❑ 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? .......................................................................... ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings1s 12 percent[72 P.S. §9116(a)(1.3)].A sibling is defined, under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.